Antibody and Viral Load Test - Doc doesnt give good info

Doc -

I've been reading a lot on this site, and have felt pretty good where I was at with an HIV test - thanks so much for what you do. To my story and my questions.

8 weeks ago I had unprotected vaginal sex. 2 weeks after the unprotected sex I came down with malaise, fatigue sore throat, a foliculitus type rash, very stuffy nose that developed into mild bronchitus (bronchitis), NO fever. These symptoms worried me, so I had an HIV 1/2 antibody test at 7 weeks, that was negative. I was feeling good about the results and my doctor said there was no need for follow up - he left a message on my machine and I never got the chance to talk to him.

A week later I went back to the doctor for other things, but my doc was on vacation. When I went in, a resident doctor came in to look at me and refrenced my HIV test. I asked if he could explain exactly what the deal was - he gave some long answer and said that it meant nothing to my possible exposure 7 weeks prior, and that only 3 and 6 months would be definitive - this freaked me out, I thought I was ok. Another doctor came in and said that if I wanted to know the exact answer that I should get a viral load test, I've now done such. Now I see online that with the viral load test there are false positives reported. I'm so frieghtened that I am HIV negative but that this will come back as HIV positive (false positive).

Questions:
1. I know the antibody test is probably in the high 90s for accuracy - any chance you could put a percentage on that?
2. If anything, does my antibody test mean 100% that the symptoms I experienced at 2 weeks were not ARS?
3. Is the ARS rash anything like foliculitus?
4. How common is a viral load test to show as false positive?
5. Should I tell the doctor to cancel the viral load test (I got it 2 days ago)?
5. I feel as though my sanity has been ripped from me by the people who are suppose to take care of me - is this something that needs to reported to my state medical board?

[Edward W Hook, MD]

Welcome to our forum.  I'm afraid the resident your discussed your results with was ill-informed.  I'll try to help. The major message I want to transmit however is that you should not freak out, there is no reason to worry about HIV based on t what you report thus far.

If your symptoms two weeks following your exposure had been due to HIV, your 7 week test would have been positive.  The symptoms of early HIV are due, in part, to formation of antibodies to HIV and the interaction of those antibodies with the virus.   In persons with symptoms due to early HIV, standard HIV blood tests are typically positive within a week of the onset of symptoms. That your tests were negative about 5 weeks after your symptoms began means that your symptoms were not due to HIV.  

Your concerns about the viral load test are correct but the odds are still that your test will be negative.  If your test is positive, we can discuss interpretation. Since I suspect that your test will be negative, I would say if they are, this is just further proof that you did not get HIV from your exposure 7 weeks ago and that you can then (now) be confident that you did not get HIV through the exposure you mentioned.

Regarding your specific questions:

1.  At 7 weeks well over 95% of persons who have recently acquired HIV will have positive tests.  Your negative 7 week test is very strong evidence that you did not get HIV.
2.  Correct- see above.
3.  No, the ARS rash is typically not follicular in nature.
4.  About 1-2% can be FP in some settings.  
5.  My guess is the test has already been done.  Probably too late to pull it back.
6.  No.  This is rather specialized knowledge and the resident you spoke with is in training. I might suggest you mention the concerns that were raised by this person’s statements but it need not be reported.  Constructive feedback however can be helpful.

I hope these comments are helpful.  EWH

[TimeToKnow]

Thank you very much doctor, I very much appreciate your answers.

It's just very frustrating to go through the waiting/anxiety, have the test be negative and feel you need no futher testing, and then all of a sudden be thrown back into the anxiety fire for no reason other then bad advice from doctors.

I will let you know what the resutls are from the Viral Load thest when I hear.